Laparoscopy: a tool for undiagnosed pain abdomen

Arpit Sharma, Deepak Sethi, Anjali Sethi
In: International Surgery Journal · 2018 · vol. 5(10) , pp. 3350 · doi:10.18203/2349-2902.isj20184087 · W2894315209
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Diagnostic laparoscopy in 60 patients with undiagnosed abdominal pain identified pathologies such as chronic appendicitis, endometriosis, pelvic inflammatory disease, tuberculosis, and adhesions, demonstrating its diagnostic utility.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This study evaluated the role of diagnostic laparoscopy in 60 patients with chronic undiagnosed abdominal pain at a tertiary care hospital, using a three-port approach under general anesthesia and then analyzing both diagnostic and procedural outcomes. On laparoscopy, key findings included chronic appendicitis (31 cases), PID with and without adhesions (8 cases total), adhesions (12 cases), suspected genital or GI tuberculosis (4 cases), and endometriosis with adhesions (3 cases), with only one negative diagnostic laparoscopy. The authors report benefits such as improved visualization, the ability to locate and treat adhesions via adhesiolysis during the same procedure, histopathology specimen retrieval, and low complication rates, while noting the primary limitation that results are based on a relatively small single-center series without detailed complication metrics in the provided abstract. This paper is centrally about endometriosis — it reports endometriosis with adhesions identified during diagnostic laparoscopy among undiagnosed chronic abdominal pain patients.

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Abstract

Background: Diagnostic laparoscopy has been in the armamentarium of the surgeon and gynaecologist for many years as a useful technique for evaluating pelvic pathology and it is now one of the most frequently performed laparoscopic procedures. The purpose of this study is to evaluate the role of diagnostic laparoscopy in undiagnosed pain abdomen. The Objectives of this study is to evaluate laparoscopy as a diagnostic tool in cases of undiagnosed abdominal pain where clinical symptoms and investigations are not conclusive and to evaluate benefits and complications of diagnostic laparoscopy.Methods: The study was done in 60 patients, presenting with chronic undiagnosed pain abdomen to a tertiary care hospital. All the patients were operated under general anesthesia in supine position. Diagnostic laparoscopy was done using 3 ports, one umbilical 10 mm, other two depending upon possible pathology. After the study, the data was analyzed to evaluate the role of laparoscopy in undiagnosed abdominal pain.Results: Out of 60 patients, 44 were female and 16 males. On diagnostic laparoscopy, findings were- chronic appendicitis - 31, chronic appendicitis with left ovarian cyst - 1, endometriosis with adhesions - 3, PID - 5, PID with adhesions - 3, suspected TB (GI/Genital) - 4, adhesions - 12, negative diagnostic lap - 1. So it may be concluded that diagnostic laparoscopy is a very useful tool to establish diagnosis in patients with undiagnosed abdominal pain with the following benefits are, superior diagnostic ability, better visualization of the abdominal cavity including the paracolic gutters and the pelvis, able to pin point the sites of adhesions with adhesiolysis during the same procedure, retrieval of specimen for histopathological examination, management of the pathology during the same procedure, avoiding unnecessary laparotomy, low complication rate.Conclusions: Laparoscopy is an efficient tool in the armamentarium of the surgeon to diagnose the patients of undiagnosed pain abdomen with numerous benefits and minimal complications.
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Background

Diagnostic laparoscopy has been in the armamentarium of the surgeon and gynaecologist for many years as a useful technique for evaluating pelvic pathology and it is now one of the most frequently performed laparoscopic procedures. The purpose of this study is to evaluate the role of diagnostic laparoscopy in undiagnosed pain abdomen. The Objectives of this study is to evaluate laparoscopy as a diagnostic tool in cases of undiagnosed abdominal pain where clinical symptoms and investigations are not conclusive and to evaluate benefits and complications of diagnostic laparoscopy.

Methods

The study was done in 60 patients, presenting with chronic undiagnosed pain abdomen to a tertiary care hospital. All the patients were operated under general anesthesia in supine position. Diagnostic laparoscopy was done using 3 ports, one umbilical 10 mm, other two depending upon possible pathology. After the study, the data was analyzed to evaluate the role of laparoscopy in undiagnosed abdominal pain.

Results

Out of 60 patients, 44 were female and 16 males. On diagnostic laparoscopy, findings were- chronic appendicitis - 31, chronic appendicitis with left ovarian cyst - 1, endometriosis with adhesions - 3, PID - 5, PID with adhesions - 3, suspected TB (GI/Genital) - 4, adhesions - 12, negative diagnostic lap - 1. So it may be concluded that diagnostic laparoscopy is a very useful tool to establish diagnosis in patients with undiagnosed abdominal pain with the following benefits are, superior diagnostic ability, better visualization of the abdominal cavity including the paracolic gutters and the pelvis, able to pin point the sites of adhesions with adhesiolysis during the same procedure, retrieval of specimen for histopathological examination, management of the pathology during the same procedure, avoiding unnecessary laparotomy, low complication rate.

Conclusions

Laparoscopy is an efficient tool in the armamentarium of the surgeon to diagnose the patients of undiagnosed pain abdomen with numerous benefits and minimal complications. Metrics

References

Udwadia TE. Diagnostic laparoscopy. In: Udwadia TE's Laparoscopic Surgery in developing countries. 1st ed. Jaypee Publications Pvt. Ltd. New Delhi; 1997:15-43. Kumar R, Saxena N, Chaudhary P, Ahirwar N, Gautam S, Munjewar C, et al. Role of diagnostic laparoscopy in patients with non-specific abdominal pain and its correlation with clinical and radiographic findings. Hellenic J Surg. 2016;88(4):268-75. Robinson HB, Smith GW. Applications of laparoscopy in general surgery. Surg Gynaecol Obstet. 1976;143:829-34. Seigler AM. Trends in laparoscopy. Am J Obst Gynaecol. 1971;109:794. Udwadia TE, Udwadia RT, Menon K, Kaul P, Kukreja L, Jain R. Laparoscopic surgery in the developing world. An overview of the Indian scene. Int Surg. 1995;80(4):371-5. Al-Bareeq R, Dayna KB. Diagnostic Laparoscopy in acute abdominal pain: 5-year retrospective series. Bahrain Med Bull. 2007;29(2):1-5. Easter DW, Cuschieri A, Nathanson LK, Lavelle-Jones M. The utility of diagnostic laparoscopy for abdominal disorders. Audit of 120 patients. Arch Surg. 1992;127(4):379-83. Lavonius M, Gullichsen R, Laine S, Ovaska J. Laparoscopy for chronic abdominal pain. Surg Laparosc Endosc. 1999;9(1):42-4. Klingensmith ME, Soybel DI, Brooks DC. Laparoscopy for chronic abdominal pain. Surg Endosc. 1996;10(11):1085-7. Nagy AG, James D. Diagnostic laparoscopy. Am J Surg. 1989;157(5):490-3. Onders RP, Mittendorf EA. Utility of laparoscopy in chronic abdominal pain. Surg. 2003;134(4):549-54. Arya PK, Gaur KJBS. Laparoscopy, a tool in diagnosis of lower abdominal pain. Indian J Surg. 2004;66:216-20. Salky BA, Edye MB. The role of laparoscopy in the diagnosis and treatment of abdominal pain syndromes. Surg Endosc. 1998;12(7): 911-4. Schrenk P, Woisetschlager R, Wayand WU, Rieger R, Sulzbacher H. Diagnostic laparoscopy: a survey of 92 patients. Am J Surg. 1994;168(4):348-51. Erach UT. Diagnostic laparoscopy. Surg Endosc. 2004;18(1):6-10. Hasson HM. A modified instrument and method for laparoscopy. Am J Obstet Gynecol. 1971;110:886-7.

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endometriosis

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